Study of the recognition in care managers who handling elderly abuse

本研究旨在探讨照护管理者面对家庭成员虐待老人时所感受到的困难。本研究以扎根理论的方法进行。参与者是处理过虐待老人案件的护理经理。研究对象均为女性，平均护理管理经验为4.3 ± 0.7年。护理管理的困难之一是：受虐待者的可怕处境不容忽视;长期护理保险服务是对这些人的唯一支持;虐待者有权取消合同;人们担心干预可能会增加虐待;优先处理虐待者而不是被虐待者是不可避免的;施虐的照料者决定需要照料的个人的需要;唯一的选择是制定一个照料者可以接受的照料计划。日 关于我们 最终提炼出的核心范畴为“虐待照顾者对照顾管理的隐性控制”。害怕面对施虐者，护理经理来访时的不受欢迎的气氛，不得不继续与施虐者的关系，不愿意破坏家庭关系，无法干预作为虐待根源的家庭关系，即使在虐待家庭中也希望相信家庭纽带。最终得出的核心类别是，由于尊重照顾者的决定的原则而无法承担虐待者的无力感。从这项研究中可以明显看出，照顾管理者认识到，在虐待案件中构成照顾管理基础的合同是导致他们遇到困难的一个因素。有人建议，有必要建立一个支持护理管理人员的制度，以促进适当的护理管理。少

The purpose of this study is to analyze the difficulties perceived by care managers who confront elderly abuse inflicted by family members. The research was executed according to the grounded theory approach. Participants were care managers who had handled elderly abuse cases. They (n=21) were all female, and had a mean of 4.3 ± 0.7 years of experience as a care manager.The cognitions kind of two difficulties was extracted from the data. One of difficulty about care management were as follows: the terrible situation of the people abused cannot be ignored; the long-term care insurance service is the only support for these people; the abusive caregiver has the authority to cancel the contract; there is concern that intervention might increase the abuse; prioritizing how to deal with the abuser rather than the abused is unavoidable; the abusive caregiver decides the needs of the individual requiring care; and the only option is to create a care plan that is acceptable to the caregiver. Th … More e core category that was ultimately extracted was "tacit control of care management by the abusive caregiver".One of difficulty about intervention to abusive families were as follows: fear of confronting the abuser, unwelcome atmosphere to care manager's visit, having to continue the relationship with an abusive caregiver, unwillingness to upset the family relationship, inability to intervene in a family relationship that is the root cause of abuse, and wanting to believe in family bonds even in an abusive family. The core category that was ultimately extracted was the feeling of powerlessness in being unable to take on the abuser due to the principle of respect for caregivers' decisions.It is evident from this study that care managers recognize that the contract that forms the basis of care management in cases of abuse is a factor contributing to the difficulties they experience. It was suggest the need to establish a system that supports care managers in order to promote appropriate care management. Less